Healthcare Provider Details

I. General information

NPI: 1922409291
Provider Name (Legal Business Name): OSBORN DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2014
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 W CENTRAL AVE
MIAMI OK
74354-6815
US

IV. Provider business mailing address

11 W CENTRAL AVE
MIAMI OK
74354-6815
US

V. Phone/Fax

Practice location:
  • Phone: 918-542-4444
  • Fax: 918-542-4441
Mailing address:
  • Phone: 918-542-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BILL OSBORN
Title or Position: OWNER
Credential:
Phone: 918-542-4444